Nursing Commons^™

Heart Failure, Meredith Louden

Nursing Student Class Projects (Formerly MSN)

Abstract

Background: Heart failure (HF) is the heart’s inability to maintain the blood flow needed by the body’s organs for perfusion. HF affects millions of adults worldwide annually and holds detrimental characteristics with its high hospitalization and mortality rates. As a result, healthcare systems spend exponentially more resources and money to take care of HF patients. An interactive poster is presented on HF to educate patients with HF, healthcare providers, and other related parties.

Methods: Research articles that focused on HF, including the following topics: pathophysiology, clinical signs and symptoms, treatment, complications, impact on healthcare, and etiology, were evaluated and …

Delirium, Angela Lee

Nursing Student Class Projects (Formerly MSN)

Delirium is a severe neurocognitive syndrome characterized by acute changes in consciousness and cognition (American Psychiatric Association, 2013; Wilson et al., 2020). The syndrome is found to be prevalent within the adult intensive care population resulting from various triggers and stressors in the critical care setting (Wilson et al., 2020). On average, the prevalence of delirium is 23%, but the incidence significantly increases to 50-70% in mechanically ventilated patients (Wilson et al., 2020). As a result of the extension of cognitive deficits, if left untreated, delirium may lead to long-term impairments in cognitive disfunction (Wilson et al., 2020). Current studies …

Current Management Of Acute Hyperglycemia: Diabetic Ketoacidosis And Hyperglycemic Hyperosmolar Syndrome, Cary Bedinghaus

Nursing Student Class Projects (Formerly MSN)

The purpose of this poster is to review and promulgate current best practices in management of the two forms of hyperglycemic crises: diabetic ketoacidosis (DKA) and hyperglycemic hyperosmolar syndrome (HHS). Reviews of literature showed large agreement on efficacious protocols in acute hyperglycemic treatment, while also noting wide prevalence of the disorder. Given the high human and financial cost of hyperglycemia, the dissemination of high quality, evidence-based interventions, to the widest possible audience participating in patient care, is imperative. This poster outlines signs and symptoms, basic pathophysiology, and implications for the treatment team with emphasis placed on areas of settled best …

Decreasing Floor Morphine Equivalents Per Day Rates In The Mother/Baby Department, Jessica Welsh

Master's Projects and Capstones

Problem: Cesarean sections (C/S) are among the most common operations in the United States and result in moderate visceral and somatic pain. Historically, C/S pain has been treated with opioid pain relievers. The U.S. Department of Health and Human Services declared the misuse of opioids an epidemic in 2017, leading healthcare providers and organizations to look inward at how opioids are prescribed and used at all levels of patient care.

Context: A microsystem assessment on a 60-bed mother/baby unit indicated one of the highest average opioid administration rates per day for postoperative C/S patients in the organization’s region for the …

Asthma Pathophysiology, Tyler Wolpert

Nursing Student Class Projects (Formerly MSN)

This poster will examine the pathophysiology of Asthma, explore signs and symptoms of the disease, and review different treatment modalities. The Doctorate of Nursing (DNP) prepared nurse should be able to identify signs and symptoms of the disease and be prepared to manage the disease from a medical standpoint, as well as with behavior modification. The economic burden of asthma on healthcare yearly is over $82 billion. It is pertinent that continued research is done in the field of asthma to reduce the economic impacts of the disease, as well as to help improve patient outcomes on people living with …

Effect Of Microbiome Alterations On The Progression & Treatment Of Nonalcoholic Fatty Liver Disease, Rachelle Virgin

Nursing Student Class Projects (Formerly MSN)

Nonalcoholic fatty liver disease (NAFLD) is the presence of hepatic steatosis that is not caused by alcohol consumption, viruses, or medications (Sivell, 2019). Fatty liver can become more inflamed and lead to nonalcoholic steatohepatitis (NASH) and possibly progress to cirrhosis and liver failure (Sheka et al., 2020). As rates of obesity and type 2 diabetes rise, healthcare providers can expect to see this disease more prevalently in practice. It can be difficult to provide timely healthcare because there are usually no signs or symptoms present with NAFLD (Mayo Clinic, 2020). This poster discusses the importance of recognizing comorbidities and risk …

Parkinson's Disease And Anesthesia, Anthony Brusadin

Nursing Student Class Projects (Formerly MSN)

Parkinson’s disease is one of the most common neurodegenerative disorders in the world and is rapidly growing. With the global population living longer there will be more people that develop Parkinson’s like the average person’s life expectancy increases. With no cure and only treatment and management of the symptoms, it is important for research to continue to find better treatment options and potentially a cure. In the world of anesthesia patients with Parkinson’s are more difficult to manage with sedation medication because of the lower dopamine levels the patient has. It is important to stay updated on how to prepare …

Cardiogenic Shock, Kourtney Crum

Nursing Student Class Projects (Formerly MSN)

Cardiogenic shock is a leading cause of mortality in critical care units globally, despite advances in research and medical management. This shock state is caused by an initial insult directly to the heart, including myocardial infarction, ventricular failure, or valve dysfunction. The purpose of this poster is to provide an overview of pathophysiology, signs and symptoms, clinical classifications, and management options for cardiogenic shock.

Sars-Cov-2 (Covid-19), Matthew Baker

Nursing Student Class Projects (Formerly MSN)

SARS-CoV-2 (COVID-19) emerged in the fall of 2019 and impacted millions of people worldwide deeming it a global pandemic. The virus primarily impacts the respiratory system, but has shown to affect other organ systems such as the kidneys, heart, and brain. Respiratory failure leading to Adult Respiratory Distress Syndrome (ARDS) associated with COVID-19 requires ventilatory support and possibly prone therapy to increase lung volumes and prevention of atelectasis. There are several treatment modalities for mild and severe cases of COVID-19 that range from antivirals to vaccine development. COVID-19 is a complex virus that can vary from mild to severe cases …

The Impact Of A Structured Civility Educational Module And Cognitive Rehearsal Training (Crt) On Job Satisfaction And Turnover In Rural Healthcare Employees: A Quality Improvement Pilot Project, Laurel Matthews

Doctor of Nursing Practice (DNP) Manuscripts

Incivility is a top-cited stressor resulting in decreased job satisfaction and turnover. Uncivil behaviors jeopardize patient safety through poor communication and team ineffectiveness. This project aimed to determine if a structured civility educational module with CRT positively impacted job satisfaction and turnover of healthcare employees.

A pretest using the Workplace Civility Index (WCI) and investigator generated questions determined current civility behaviors, notable civility issues, and attitudes surrounding job satisfaction and turnover. The interactive, virtual modules highlighted dilemmas regarding incivility and their consequences to patient care. During CRT, the participants responded to filmed, uncivil conflicts using provided frameworks to curate civil …

Effectiveness Of The Purewick External Urinary Collection Device In A Long-Term Acute Care Hospital: A Program Evaluation, Charlotte Sheppard

Doctor of Nursing Practice (DNP) Manuscripts

In December 2017 a 77 bed Long Term Acute Care Hospital (LTACH) added PureWick External Urinary Collection Devices (ECD) to their Hospital Acquired Infection (HAI) Bundle. The PureWick ECD is utilized in the female patient population when urinary management is necessary and can be achieved without an indwelling urinary catheter.The PureWick ECD is a flexible wick like external catheter that allows for collection of urine through the hospital wall suction system. A program evaluation was performed relative to a program beginning in January, 2018 through September 2020 to determine if the implementation of the PureWick ECD reduced the catheter associated …

Improving Progressive Care Nurses’ Confidence And Performance During In-Hospital Cardiac Arrest (Ihca): A Continuous Quality Improvement Initiative, Katelyn Barley

Doctor of Nursing Practice (DNP) Manuscripts

The literature is clear regarding the benefits of high-quality cardiopulmonary resuscitation (CPR) in relation to patient outcomes. The American Heart Association (AHA) guidelines recommend immediate initiation of chest compressions and defibrillation as soon as possible to increase the chance of survival from cardiac arrest. The development of automatic external defibrillators (AEDs) have increased the survival rates of out-of-hospital cardiac arrest, however rates of survival from in-hospital cardiac arrest (IHCA) have not improved over the past several decades despite an increase in resuscitation research.

This project was to develop a system of quality improvement related to patient outcomes from IHCA. The …

Use Of A Remote Patient Home Telemonitoring System (Engage Practice Solutions) In A Rural Health System To Decrease Rural Patients’ Utilization Of Acute Healthcare Services: A Quality Improvement Project, Christopher Baker

Doctor of Nursing Practice (DNP) Manuscripts

Individuals in rural areas of the U.S. have less healthcare access in large part due to access barriers, and include travel and wait time, distance to a provider, cost, transportation, and social and cultural components. Rural individuals have been found to be in poorer health and have higher rates of being uninsured and having chronic disease. These disparities lead to rural individuals requiring more expensive acute care once they are at the point of receiving care. A significant burden is placed on the individual and health system. The rates of emergency department (ED) use in rural areas increased 70% from …

University Student Health Services Covid-19 Pandemic Response: A Program Evaluation, Joy Dougherty

Doctor of Nursing Practice (DNP) Manuscripts

The COVID-19 pandemic began in China in December 2019, and continued to spread globally throughout the following months. The impact of the virus led to Universities nationwide closing their campuses. Strategic COVID-19 master plans were created to ensure that students, faculty, and staff could return to a safe environment for the fall semester. The role of University Student Health Services (SHS) departments became critical.

The SHS team incorporated telemedicine visits along with new policies, procedures, protocols, and guidelines to maximize the safety of the students, faculty, and staff upon their return to campus. This program evaluation focused on the strengths …

An Evalution Of Sepsis Initiatives To Reduce The Severity Of Severe Sepsis In A Two-Hospital System, Rosemary Reiner

Doctor of Nursing Practice (DNP) Manuscripts

Sepsis is the most expensive clinical condition to treat, with a very high mortality rate (Torio & Moore, 2016). The goal of sepsis treatment is to intervene as early as possible utilizing established criteria. Several evidence-based approaches in the literature address early identification of sepsis, decreasing sepsis severity and reducing morbidity and mortality. Clinical Decision Support (CDS) are tools within certified electronic health records that provide clinicians with patient-specific knowledge presented at appropriate times that enhance decision-making and improve patient outcomes (Villegas & Moore, 2018). Electronic sepsis alerts are examples of CDS that are developed to monitor changes indicative of …

"Program Evaluation On The Use Of The Screening, Brief Intervention And Referral To Treatment (Sbirt) Process In Primary Care Physician Offices", Lisa Sanchez-Navarro

Doctor of Nursing Practice (DNP) Manuscripts

Screening, Brief Intervention, and Referral to Treatment (SBIRT) is an early screening intervention tool for individuals with non-dependent substance use, which is employed to identify and provide care before a patient needs extensive specialized treatment. SBIRT can be used in primary care settings, to methodically screen individuals who might not seek help for a substance use issue (Centers for Medicare & Medicaid Services, [CMS], 2020). Gaps in using the SBIRT screening process were identified within the insurance organization’s PCP practices, therefore, a program evaluation was completed to: (a) determine whether Primary Care Physicians (PCPs) were using the SBIRT process, (b) …

Patient Portal Use, Health Information Technology Self-Efficacy, Electronic Health Literacy, And Self-Management Among Patients With Heart Failure: A Cross Sectional Study, Pamel Kallmerten

Electronic Theses and Dissertations

Background: By the year 2030, the prevalence of heart failure (HF) is anticipated to rise by 46%, impacting over 8 billion persons. Self-management of HF is key to maintaining a healthy lifestyle and quality of life. Yet many have sub-optimal self-management skills necessitating innovative strategies to enhance self-management. An innovative strategy to support the person with HF is the use of health information technology (HIT) such as a patient portal (PP). Additionally, self-efficacy and health literacy are important to self-management of HF. Further understanding is needed of the relationship between PP use, HIT self-efficacy (HIT SE), electronic health literacy …

Technological Change And The Practice Of Healthcare Communication: Implications For Patient-Centered Care, From A Communication Ethics Perspective, Emmalee Torisk

Electronic Theses and Dissertations

Written in a historical moment marked in many ways by the COVID-19 pandemic and the changes it has wrought, including the increased availability and use of telehealth services, this project attempts to consider the implications of the continued integration of technology into health care, centering on the following essential question: How do technological changes affect the contemporary practice of healthcare communication, particularly that which occurs between the patient—the consumer of health care—and their provider? This dissertation thus considers the ways in which such linkages of technology and health care seem to fit into a larger shift within health care …

Engaging Middle School Students And Parents/Guardians Via Structured Virtual Media On Food Allergy And Anaphylaxis Awareness: A Quality Improvement Project, Jodi Licata

Doctor of Nursing Practice (DNP) Manuscripts

Abstract

Background and Significance: More than 40% of children with food allergies have experienced anaphylaxis, a life-threatening condition (Food Allergy Research & Education [FARE], 2021). Anaphylactic reactions require immediate treatment with an intramuscular injection of epinephrine by a health care professional or by a self-injectable epinephrine auto-injector device. If anaphylactic symptoms are not promptly recognized and treated, fatal consequences may occur (FARE, 2021). Repeated education, training, and a supportive social environment, specifically with adolescents, have been found to facilitate self-management with food-induced anaphylaxis (Comberiati et al., 2019). Purpose: In this quality improvement project, virtual education interventions to increase food allergy …

The Use Of Isbared/Ishaped And Elimination Of Reviewing Patients’ Chart Before Handoff To Decrease Incremental Overtime, Sheila Bucao

Master's Projects and Capstones

Problem: Incremental overtime was found to majorly impact the financial well-being of a stroke unit. From an allocated budget of 22 hours per pay period, the unit’s incremental overtime averaged 40 hours. The stroke unit had skilled-mix competencies, further complicating handoffs. The absence of a standard reporting method means that reviewing patients’ charts takes approximately 10 to 15 minutes, extending what should be a quick, but thorough nurse knowledge exchange.

Context: The body of evidence reviewed indicated that pertinent information to patient care is not left out or missed when a standardized tool is used during handoff. Based on Lean …

Malignant Hyperthermia, Emmanuel Mensah

Nursing Student Class Projects (Formerly MSN)

Malignant Hyperthermia is a rare but fatal disorder usually triggered using succinylcholine, a depolarizing muscle blocker, or other volatile anesthetics (Yang et al., 2020). MH is characterized by signs and symptoms including Hyperthermia, acidosis, tachycardia, hypercarbia, acidosis, etc. (Yang et al., 2020). When the signs and symptoms of MH are recognized, the provider should stop what he or she is doing and call for immediate help. When additional assistance arrives, the patient must receive Dantrolene. Dantrolene is a muscle relaxant that prevents the sarcoplasmic reticulum from releasing calcium. Additional interventions include cooling the patient using ice packs, treating electrolyte abnormalities, …

Alcohol Use Disorder (Aud) In The Elderly Population, Anthony Oguogho

Nursing Student Class Projects (Formerly MSN)

There is a substantial and growing population of elderly adults (65years and older) who misuse alcohol, and psychoactive prescription drugs. Evidence suggests that alcohol dependence and alcohol abuse which is now collectively known as alcohol use disorder (AUD) is common among 65years and older due to socioeconomic circumstances of aging. These socioeconomic circumstances include empty nest syndrome (when children grow up and move away), loss of friendships due to moves, health complications or death, deteriorating health conditions, traumatic events like a spouse’s illness or death, sadness after downsizing a home, and boredom from retirement or lack of socialization. ETOH is …

Chronic Obstructive Pulmonary Disease, Aaron Mcneilan

Nursing Student Class Projects (Formerly MSN)

The following poster presentation provides a brief overview of the disease process of Chronic Obstructive Pulmonary Disease (COPD). COPD is one of the leading causes of disability and death worldwide, and its incidence does not appear to be declining. The most common factor causing COPD is cigarette smoking, which is modifiable. Other contributors are environmental air pollutants which some people may encounter depending on where they live or their occupation. This presentation is a culmination of information from different scholarly sources which discuss the symptoms, pathophysiology, causes, management, and prevention of COPD.

Polycystic Ovarian Syndrome: Pathophysiology And Chronic Health Implications, Makilah Witt

Nursing Student Class Projects (Formerly MSN)

Polycystic Ovarian Syndrome (PCOS) is the most common endocrine disorder affecting women of reproductive age. If untreated, women suffer a myriad of secondary sequala and chronic diseases. The prevalence of PCOS is rising and greatly impacts patients' physical, mental, and emotional health, diminishes community health, and increases healthcare costs. However, many providers fail to properly diagnose patients, understand how this disease impacts women, or provide appropriate interventions to prevent chronic health problems. This paper outlines the pathophysiology of PCOS, identifies signs and symptoms, and provides recommendations for treatment and holistic patient care for the role of the Advance Practice Nurse.

Recruitment And Retention Of Minority High School Students To Increase Diversity In The Nursing Profession, Denise Dawkins

Faculty Research, Scholarly, and Creative Activity

No abstract provided.

Post-Discharge Phone Calls In The Emergency Department: Do Follow-Up Calls Increase Patient Satisfaction And Reduce Post-Discharge Complications?, Saraann K. Fagan

Doctor of Nursing Practice Scholarly Projects

Improvements in discharge instructions are necessary in emergency departments (EDs) across the United States (US). Multiple factors, such as the fast-paced environment and varying levels of acuity in the ED, contribute to inadequate discharge instructions and change is necessary to further prevent negative outcomes. The purpose of the evidence-based practice project was to implement post-discharge follow-up phone calls to ED patients to improve patient satisfaction scores regarding discharge instructions for at-home care and to reduce post-discharge complications. The project was implemented over a three-month period in early 2021 in the ED of a local hospital in Charleston, South Carolina (SC). …

Reduction Of Clabsi In Telemetry Patients Through Limiting Central Line Blood Draw, Caselyn Lok

Student Scholarly Projects

CLABSI is known to be one of the many healthcare-associated infections that has led to an increase in health complications, length of hospital stays, and increased in healthcare cost. There is about 25000 bloodstream infection that occurs annually (Haddadin, Annamaraju, & Regunath, 2020). The PICOT question that guided this project was “How does limiting blood-draw from central venous catheter lines influence the rate of central-line associated bloodstream infections (CLABSI) post-implementation compared to rate of CLABSI pre-implementation after eight weeks?” CLABSI prevention bundles were already being used to guide healthcare providers in handling CVC access. There were 15 scholarly articles that …

Implementing An Inpatient Virtual Discharge Nurse Program – Riding The Wave Of Technology At The Bedside, Marjorie Lavin Rn, Bsn, Jaclyn Stine Bs

Posters

No abstract provided.

Nurse Retention In Workplace Adversity, Deborah Lewis

Student Scholarly Projects

Practice Problem: Nurse turnover rate and lack of retention are issues that have an impact on safe patient care, patient mortality, quality outcomes, and patient experiences in the acute care units at the identified project setting. Turnover leads to excess labor utilization of overtime and increased hospital costs.

PICOT: The PICOT question that guided this project was (P) In acute care hospital nurses, how do (I) nurse retention strategies (C) compared with no nurse retention strategies (O) reduce nurses’ intention to leave and increase job satisfaction over (T) eight weeks?

Evidence: Twenty-one articles were reviewed that identified autonomy, recognition, …

Peer-To-Peer Emotional Support For Second Victims Of Hospital Adverse Events, Jessica L. Van Leuven

Master's Projects and Capstones

Abstract

Problem: Psychological impact of trauma on healthcare workers is profound, and if left unaddressed can debilitate its victims, depress morale, and undermine safety culture. When adverse events occur and focus is placed on providing care and support to patients and their families, the emotional support needs of healthcare workers must also be acknowledged.

Context: Frontline workers in the oncology unit of the medical center that is the setting for this project experience emotional distress as “second victims” of adverse patient events. Close relationships develop between providers and patients during long-term treatments. When unanticipated or adverse patient events there can …